Int J Thyroidol.  2017 Nov;10(2):118-122. 10.11106/ijt.2017.10.2.118.

Cervical Bronchogenic Cyst Mimicking Thyroid Cyst

• Kang SH
• Jin SM
• Kim HK
• Yoon TM

• KMID: 2396817
• DOI: http://doi.org/10.11106/ijt.2017.10.2.118

Abstract

Bronchogenic cysts are rare congenital malformations that result from an abnormal development of the ventral foregut budding of the tracheobronchial tree at the time of organogenesis. They are usually located in the mediastinum and intrapulmonary regions. Localization in the cervical area is unusual, and specially, bronchogenic cysts presenting as thyroid and perithyroid cyst are quite rare. We report a case of bronchogenic cyst mimicking a thyroid colloid cyst. We tried percutaneous ethanol injection at 3 times for treatment of this thyroid cyst, but we failed, because of intractable cough. After cyst excision with thyroid lobectomy, we diagnosed the lesion to bronchogenic cyst. Bronchogenic cyst should be considered in the differential diagnosis of perithyroid cyst, which especially the lesion is intolerable cyst to enthanol injection.

Keyword

Bronchogenic cyst; Thyroid cyst; Colloid cysts; Sclerotherapy

MeSH Terms

Bronchogenic Cyst*
Colloid Cysts
Cough
Diagnosis, Differential
Ethanol
Mediastinum
Organogenesis
Sclerotherapy
Thyroid Gland*
Trees
Ethanol

Figure

• 

  Fig. 1 CT scans with contrast enhancement shows 5×5 cm well-defined cyst, originated from right thyroid gland, extending to upper mediastinum. (A, B) Axial views, (C) Coronal view.

• 

  Fig. 2 Thyroid US reveals 5×5 cm sized hypoechoic pure cyst with multiple comet-tail artifact at lower pole of right thyroid lobe.

• 

  Fig. 3 (A) Operative finding shows that superior part of the cystic wall is composed of cartilage and connected to first ring of trachea. (B) This operative photo reveals that the cystic wall is attached to the recurrent laryngeal nerve. (C) Photo of the surgical specimen shows about longitudinal 5 cm sized cystic mass at inferior portion of right thyroid lobe. arrows: recurrent laryngeal nerve, C: cyst, Th: thyroid gland, Tr: trachea

• 

  Fig. 4 Histopathologic photo shows that cystic wall contains mucoserous glands (arrowhead) and hyaline cartilage (arrows), which is consistent with bronchogenic cyst (H&E staining, ×100). Cystic lesion is lined by respiratory type epithelium (inlet, H&E staining, ×200).

Reference

1. Newkirk KA, Tassler AB, Krowiak EJ, Deeb ZE. Bronchogenic cysts of the neck in adults. Ann Otol Rhinol Laryngol. 2004; 113(9):691–695.

2. Shimizu J, Kawaura Y, Tatsuzawa Y, Maeda K, Suzuki S. Cervical bronchogenic cyst that presented as a thyroid cyst. Eur J Surg. 2000; 166(8):659–661.

3. Barsotti P, Chatzimichalis A, Massard G, Wihlm JM. Cervical bronchogenic cyst mimicking thyroid adenoma. Eur J Cardiothorac Surg. 1998; 13(5):612–614.

4. St-Georges R, Deslauriers J, Duranceau A, Vaillancourt R, Deschamps C, Beauchamp G, et al. Clinical spectrum of bronchogenic cysts of the mediastinum and lung in the adult. Ann Thorac Surg. 1991; 52(1):6–13.

5. Zvulunov A, Amichai B, Grunwald MH, Avinoach I, Halevy S. Cutaneous bronchogenic cyst: delineation of a poorly recognized lesion. Pediatr Dermatol. 1998; 15(4):277–281.

6. Rao GP, Bhaskar G, Reddy PK. Cervical intradural extramedullary bronchiogenic cyst. Neurol India. 1999; 47(1):79–81.

7. Constant E, Davis DG, Edminster R. Bronchogenic cyst of the suprasternal area. Case report. Plast Reconstr Surg. 1973; 52(1):88–90.

8. Jiang JH, Yen SL, Lee SY, Chuang JH. Differences in the distribution and presentation of bronchogenic cysts between adults and children. J Pediatr Surg. 2015; 50(3):399–401.

9. Ribet ME, Copin MC, Gosselin BH. Bronchogenic cysts of the lung. Ann Thorac Surg. 1996; 61(6):1636–1640.

10. Goswamy J, de Kruijf S, Humphrey G, Rothera MP, Bruce IA. Bronchogenic cysts as a cause of infantile stridor: case report and literature review. J Laryngol Otol. 2011; 125(10):1094–1097.

11. Trossman CM. Push-up stridor caused by a bronchogenic cyst. Am J Dis Child. 1964; 107:293–296.

12. Suen HC, Mathisen DJ, Grillo HC, LeBlanc J, McLoud TC, Moncure AC, et al. Surgical management and radiological characteristics of bronchogenic cysts. Ann Thorac Surg. 1993; 55(2):476–481.

13. Touloukian RJ. Air filled bronchogenic cyst presenting as a cervical mass in the newborn. J Pediatr Surg. 1982; 17(3):311–312.

14. Lee JD, Koh YW, Lee SW, Kim HK. A case of cervical bronchogenic cyst presenting as a thyroid tumor. Korean J Otolaryngol-Head Neck Surg. 2006; 49(1):98–101.

15. Hazenberg AJ, Pullmann LM, Henke RP, Hoppe F. Recurrent neck abscess due to a bronchogenic cyst in an adult. J Laryngol Otol. 2010; 124(12):1325–1328.

16. Jeon HG, Park JH, Park HM, Kwon WJ, Cha HJ, Lee YJ, et al. Non-infected and infected bronchogenic cyst: The correlation of image findings with cyst content. Tuberc Respir Dis (Seoul). 2014; 76(2):88–92.

17. Kiralj A, Vuckovic N, Mijatov I. Congenital cervical bronchogenic cyst: A case report. Srp Arh Celok Lek. 2015; 143(5-6):317–321.

18. Liu Z, Tian Z, Zhang C, He Y. Ectopic congenital bronchogenic cyst accompanied by infection appearing in the cervical region of an elderly female patient: A case report. Oncol Lett. 2016; 11(2):1065–1068.

19. Lee DH, Yoon TM, Lee JK, Lim SC. Bronchogenic cyst in the head and neck region. J Craniofac Surg. 2017; 28(4):e303–e305.

20. Ustundag E, Iseri M, Keskin G, Yayla B, Muezzinoglu B. Cervical bronchogenic cysts in head and neck region. J Laryngol Otol. 2005; 119(6):419–423.

21. Reverter JL, Alonso N, Avila M, Lucas A, Mauricio D, Puig-Domingo M. Evaluation of efficacy, safety, pain perception and health-related quality of life of percutaneous ethanol injection as first-line treatment in symptomatic thyroid cysts. BMC Endocr Disord. 2015; 15:73.